Grattan: Australia risks a virus second wave

The Grattan Institute has released a report arguing “the fight against COVID-19 is not yet over” and warning that Australia faces a second wave of infection:

Australia’s response passed through four phases – containment, reassurance amid uncertainty, cautious incrementalism, and then escalated national action – as the gathering storm of the pandemic became more apparent. Now we are in the fifth phase – transition to a new normal.

There were four key successes in the response: cooperative governance informed by experts (most notably seen in the establishment of the National Cabinet), closure of international borders and mandatory quarantine, rapid adoption and acceptance of social distancing measures, and expansion of telehealth…

But unfortunately there were also four key failures: the mishandling of the Ruby Princess cruise ship had fatal results, borders weren’t closed quickly enough, some aspects of the health system response were too slow, and there were mixed messages about what was expected of the population.

Australia is now in the fifth phase, a transition to ‘a new normal’. Unless or until there is a vaccine, this stage has no endpoint. We all will live with the risk of more outbreaks and shutdowns, and the need for vigilance and swift responses to outbreaks..

Australia has not yet won the battle against COVID-19, and coming out of lockdown risks a second wave of infections.

Grattan Institute modelling shows that reopening shops, schools, and workplaces heightens the risk of new infections, especially if people think the threat is over and ignore social distancing rules.

Workplaces are particularly high risk and should be re-opened slowly, with as many people as possible continuing to work from home to minimise the potential for the virus to spread.

Schools should enforce social distancing policies, and close if a COVID-19 case is detected.

Mandatory quarantining of international arrivals must remain in place.

And if a second wave of mass infections breaks out, governments will have to reimpose lockdowns.

It’s dangerous for people to think this fight is over. The nature of the virus hasn’t changed – our behaviour has.

If Australians go back to a pre-COVID normal, the virus could spread quickly and wildly, like it has elsewhere.

Some of Australia’s states have effectively eliminated local transmission of COVID-19, and are keeping their borders closed to states where it persists. States should maintain different restrictions if they have different rates of local transmission.

Restrictions are obviously needed much less in states which have effectively eliminated the virus from their local population.

Australia should learn lessons from the way the health system responded to the pandemic.

Telehealth has been embraced by doctors and patients; it should now be expanded to give more people quicker access to care.

Mental health and hospital-in-the-home services should be bolstered.

And the federal and state governments need to strengthen supply chains to ensure adequate supplies of personal protective equipment and ventilators in the event of a second wave of COVID-19 infections.

If Australia gets this transition to a ‘new normal’ wrong, we won’t benefit from the overdue health system changes that the crisis forced on us. That would be another tragedy on top of the trauma caused by the pandemic itself.

Full report here.

Leith van Onselen

Comments

  1. Hasn’t had the first yet!!!! Australia closed down without an infection rate, incurred all the costs – for what?

      • It is now (with the exception of Oz and NZ) an epidemic, not a pandemic. You can never get rid of it. The uncomfortable truth, it affects the sick and dying. For most of us, the risk of dying equivalent to a 450km trip in a car. That is not to say it won’t eventually become a major killer, it could be in the top five.

        But we don’t going into lockdowns just in case some of us have heart attacks! Life is to be lived, and if possible, enjoyed.

        • Torchwood1979

          WTF!!!
          1. Heart attacks aren’t contagious
          2. Yes life is meant to be enjoyed but it’s a little hard when there are mass deaths or people are impaired for years/life and that’s before you consider the impact this has on all their loved ones.

  2. Where is the part about holding to account those that have acted against our interests.
    Specifically those foreign owned spy fake corporations that are deliberately here for the china that stripped tons of quality assured PPE from Australians and shipped it to their masters overseas,
    Why have they not been punished for their role in this emergency created by the china.
    Close the companies and confiscate all company assets to compensate the taxpayers.
    All staff that are non citizens deported immediately with all their assets confiscated to compensate the tax payers
    The CEO’s jailed for 10 years, all personal assets confiscated, then citizenship revoked and deported.
    All staff that received citizenship in the last 10 years to have it revoked and deported, assets confiscated to compensate the taxpayers.
    Where is the international court case to sue the china for trillions in compensation for the damage to our economy cause by them.

    • Ronin8317MEMBER

      Companies like Chemist Warehouse made a lot of money buying PPE from China, then selling it back to China with a hefty margin.

  3. Australia is not risking second wave, Australia is getting second wave, and third and fourth …

    only fools can think it’s avoidable

    • Arthur Schopenhauer

      Austria 🇦🇹 has done very well for a landlocked country with major freight routes run mining through it.

      • Austria only counts a Covid case, if in a hospital, and only when there are no secondary effects. For instance, if you have cancer, but develop Covid symptoms and die of pneumonia, cause of death is cancer, despite the fact that is not what actually killed you. Same occurs in Germany. You could easily quadruple those numbers and still be conservative. Most older people have secondary health symptoms, its the challenge of getting older; which automatically precludes them from being officially counted.

    • yes its a well known medical fact that you are not contagious for any disease you may have until you are told you are by a third party. Thats just basic medicine.

    • And if all those shoppers had been wearing masks, like the majority of BLM protesters, there would have been little risk. Ditto the staff of the hotels in isolation.

      Why don’t the testing facilities hand out masks with instruction to wear them until the results come in, at the very least. You can hardly blame the population when the direction from the top is so lax, deceptive and counterintuitive.

      Our leaders’ sense of exeptionalism that we don’t have to do what other (Asian) countries have had to do beggars belief.and will be our undoing.

      • Health advice from os is that masks cut down unintended transmission from the asymptomatic. Have ordered masks for family as I expect that part of living with covid pre vaccine will be social expectation that we wear masks when we are out. Which is the reverse to current healrh advice but US has done recent studies showing masks effective at reducing transmission to others.

        • Very wise, Curious . I ordered them for my family back in February and had no trouble getting them. Ordered small ones for the little ones too.

          I heard Australia’s Chief of epidemiology interviewed on RN a couple of weeks back and she said N-95 masks cut down 95% of transmission, which if combined with social distancing, would render the wearer pretty immune.

          She also said that shields are similarly effective. I’ve ordered a few of those also, as wearing the masks for any length of time is uncomfortable and not great for the lungs due to partly re-breathing your own carbon dioxide, not fresh oxygen. They’re pretty inexpensive and are wipe-downable. She also said masks and shields are pretty effective if worn around the home if any members have the virus – and that she wears a mask whenever out, and also always around her elderly parents.

          I do too. It should be regarded as a common courtesy if we had the right leadership. Covering their backsides now I guess.

  4. Display NameMEMBER

    My iphone updated on the weekend and automatically installed the Corona virus tracking app. Not only that but use mobile data option was on. And I had not explicitly agreed to the apps installation or its use of data. I have deleted the app. Very,very intrusive.

  5. Regarding the Grattan comment that our governments need to “strengthen supply chains of PPE in the event of a second wave”:-

    It also beggars belief that after four months we have not already set this in train – and whilst printing money hand over fist for business and the ASX, have not found the funds to start our own manufacture of N-95 masks for the whole population

    • Yes.
      The case fatality rate is 25.9%, which looks horrendous. This was 432 deaths in 1,667 cases.
      BUT, they estimated there were an additional 72,422 cases that were not diagnosed. Adding this to the denominator reduces the fatality rate (now called an infection fatality rate) to 0.6%.
      This figure of 0.6% is a population average. It is 0.1% for less than 69 yrs, and 4.3% for older than 70 yrs.
      That is the Swedish data.

      This figure of 0.6% is very similar to the CDC analysis (0.4% overall)
      https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html
      It is also very similar to the Australian meta-analysis of 0.5-0.6%
      https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v3.full.pdf html

      Not that I expect these figures will make the slightest difference to the views of some here.

    • @BtoB
      Read on McDuff –
      “…and for those of age 70 years or older our estimate is 4.3% (c.i. 2.7–7.7%). Most of the uncertainty in our estimations concerns the relationship between the total number of infections and confirmed cases…..Additional analysis of excess mortality in the Stockholm region during the period studied suggests that our estimate is likely to be conservative.”

      So it’s quite acceptable that up to 7.7% of those over 69 die? Not to mention the many reports now out on the many possible long-term serious side-effects of the virus, such as debilitating fatigue, pain, shot lungs, hearts, kidney, liver etc.

      The Swedes wouldn’t be trying to cover their ars*s by any chance would they, given their high infection rate?

      • BoomToBustMEMBER

        Simple, for those 70 and over work to ensure they are healthy and looked after, for everyone else let’s get on with life. Locking down all the healthy people and destroying the future prospects of the youth all while ensuring that those who have had a good life and hold the wealth are safe and secure. Sounds fair doesn’t it.

      • Thats a straw man argument. No one is saying 7.7% over 69 die. And no one is suggesting that would be acceptable.

        Firstly, one limitation of the Swedish data is they have applied a single cut-off (age 70) to a continuous curve (mortality V age). Your mortality doesn’t suddenly go from 0.1% at 69 to 4.3% at 70.
        Putting all the young adults in the under 69 group reduces the mortality of the 60-69 cohort.
        Putting all the 80’s and 90’s in the over 70 group increases the mortality of 70-79 cohort.
        This is one reason the CDC study looked at a number of age stratifications rather than a simple cut-off.

        The other issue is that you have selected the 95th CI of 7.7%. I can equally quote the 5% CI of 2.7%. However I chose to give the median at 4.3% as this is the best guess point estimate.

        Most seriously however, you have ignored the bigger issue in your desire to split hairs
        The Swedes have an IFR of 0.6%
        The CDC came up with 0.4%
        The meta-analysis suggested 0.5-0.6%
        All of these may be confounded by additional deaths that were never diagnosed as COVID.
        Equally however, the IFR may come down a bit e.g. conformation dexamethasone at an appropriate dose is beneficial. The trick is finding the Goldilocks “just right” dose as too much was very bad for SARS.

        Bottom line – the infection fatality rate is under 1%. And way under if you are under 70.

        Is it bad luck to be over 70 or over 80? Yes. The mortality of every condition increases with age. Wine improves with age. People’s physiological reserve does not however.

        The lesson from Sweden is to shield the elderly. That have acknowledged this as a failing.

        Understand also that there is a death rate associated with extreme isolation. Mental health presentations are sharply up. Suicide up. Domestic violence up. Child abuse up.

        A small % of people get serious sequelae of any infection – measles, pertussis, influenza etc. This virus will be no different. Most will have no complications. A few unlucky people will.

        • Steve … let’s say IFR is 0.5% for my arithmetic. The thing about COVID is the rapid spread.
          In Australia let’s say population 25m, and assuming no health measure has any effect, then herd immunity at 70% means eventual total deaths 25m*70%*0.5%=87500. Would take a couple of years to spread that far, but what stops it? Additionally, if hospital resources are overwhelmed, then my lunch money is on that IFR going up.
          Which is why the public health message is about stopping the spread … which has kept the death toll at just over 100.

          I accept that this approach is very costly, and a theoretical alternative is to somehow sequester the elderly and the unhealthy middle aged in a bubble … but I don’t see that that is practically possible. ‘At risk’ people still have to interact with others to get supplies. Some of them need nursing. We already have mismanaged nursing homes and horror stories from those and you expect them to step up for a COVID challenge to shield them?

          Additionally people suck at social distancing, and they cannot get their heads around asymptomatic spread. Yes they are responsible adults and well intentioned but the social conditioning that kicks in before their brains sabotages rational infection control efforts. Which makes them very dangerous because they don’t see the harm they are doing before it is too late. That’s how 6 security guards get the virus at quarantine hotels and then unknowingly bring it home.

          The only approach so far that works is the pre-emptive one, hence the social distancing, masks, wfh. A lower cost way that works would be wonderful, just haven’t seen it yet.

          • The IFR in Australia should be a bit lower than global due to significantly lower median age of population.

            It has been postulated a population has some innate immunity due to exposure to other CV over time. This theory fits with the data it hasn’t killed anything like 0.7×0.005 of a population even in areas where it hit hard. Serosurveys show it has dramatically slowed down when 20-25% of population have antibodies. That should not happen if the herd threshold is 70% as initially suggested. Time will tell.

            I don’t know we will stop it. We may just have to live with this – at least it is not as bad as initially believed.

            We may get a vaccine. But despite best efforts we may not. We have failed with previous CV research.

            I started my medical career when HIV appeared. Back then we were hearing we should have a vaccine in a couple of years. That was 49 years ago.